THE OTHER SHOE DROPS: Updates To Previous Posts
† What’s Wrong With This Picture?: Treasury Undersecretary Stuart A. Levey told the Senate Finance Committee that, “Saudi Arabia today remains the location where more money is going to terrorism, to Sunni terror groups and to the Taliban than any other place in the world.” The Bush administration's point man on financial counter-terrorism testified before the committee, which had ordered “an independent review of the efforts to choke off financing used by Al Qaeda and other extremist groups,” reports the Los Angeles Times. The paper recently reported that “the U.S.-led effort to choke off financing for Al Qaeda and other terrorist groups is foundering because … extremist groups have blunted financial anti-terrorism tools by finding new ways to raise, transfer and spend their money. … Many current and former officials and experts say that because of political, legal, cultural and technical problems, the administration-led [international] coalition is deteriorating.” Meanwhile, The New York Times reports that military investigators in Iraq found American-made computer circuits sold to a company in the United Arab Emirates in detonators of roadside bombs, and that the Bush administration threatened export controls after “aircraft parts, specialized metals and gas detectors that have potential military use had also moved through Dubai, one of the emirates, to Iran, Syria or Pakistan.” The UAE also has “deep economic and cultural ties with Iran, which is only about 70 miles across the Persian Gulf from Dubai.”
† Fed Up With Farmers: The New York Times profiles Clarks Summit, PA tomato farmer Keith Eckel, 61, whose supply of illegal immigrants to pick his crops has dried up and may force him out of business after 35 years:
“Over the last couple of growing seasons, farmers have been feeling a tremendous amount of stress over the way this issue has been playing out,” said Gary Swann, governmental relations director for the Pennsylvania Farm Bureau. “And if people think all we have to do is raise wages and hire local workers, they are simply mistaken.”
Local workers will not do the job, Mr. Swann said.
It is a claim hard to verify, farm experts say, because harvesting “specialty crops,” as the federal government refers to anything that is picked by hand - in other words, not wheat, corn or other crops harvested by giant machines - has been the domain of migrant workers since the turn of the last century [emphasis, The Stiletto’s]. …
“This is all about economics,” Eckel tells The Times. For employers and companies that use forged documented aliens to hold down their costs and maximize their profits by undercutting those who play by the rules, it’s all about the money. For the rest of us, it’s about identity theft, flouting U.S. sovereignty and compromising national security.
† Why Middle Class Americans Can’t Afford Health Insurance: Part II: Last month, NY Attorney General, Andrew Cuomo subpoenaed several health insurance providers, amongst them Aetna, Cigna, the UnitedHealth Group and WellPoint in an effort to determine how they “set payment rates for medical treatments that resulted in consumers being reimbursed at unjustifiably low rates. Low reimbursements mean higher out-of-pocket costs for consumers when they choose or need doctors outside their health plans,” reports The Associated Press. Cuomo also wants to subpoena testimony from the CEOs of these companies “to determine if the companies knew they were relying on artificially low reimbursement rates for customers and if the companies’ investors knew of the practices.”
CA is taking a different approach: Instead of finding out why insurance companies are reimbursing patients at artificially low rates for medical treatment, Gov. Arnold Schwarzenegger's administration wants emergency room doctors, radiologists and anesthesiologists to knock their fees down to what HMOs are willing to pay. Reports the Los Angeles Times:
Those doctors often work in hospitals but don't have contracts with the same health maintenance organizations that serve the hospitals. Believing the reimbursements they receive from insurers are too low, providers send additional bills to patients for the difference. Many patients wrongly assume that bill is the invoice for their co-payment and is authorized by their HMO. …
"Balanced billing," as the practice is called, is regulated in eight states. But versions of legislation to control it have repeatedly died in Sacramento amid opposition from either providers or insurers. …
The draft regulations would prohibit hospitals and hospital-based physicians from billing a patient for the cost of emergency services that are the responsibility of the patient's health plan. The state's main doctors' lobby said the new rules, if approved by the department after a public comment period that ends May 12, could backfire by causing physicians to send the entire bill to patients to let them haggle with insurers for repayment.
"This is a total giveaway to the HMOs," said Francisco Silva, general counsel for the California Medical Assn. He said specialists will be less inclined to be on call for emergencies. …
Many doctors say they are simply trying to collect their full rate. ...
[S]ome insurers have paid doctors below their "reasonable and customary" rate -- the legal standard for reimbursements. In 2005, state regulators fined Health Net $250,000 for underpaying emergency room doctors and other physicians in hospitals. The department said the Woodland Hills HMO had underpaid more than 65,000 claims.
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